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Rural Health
Resources by Topic: Reimbursement and payment models

Access to Rural Home Health Services: Views from the Field
Describes current issues affecting access to rural home health services, with an emphasis on Medicare-reimbursed programs. Based on published research, gray literature, and telephone interviews with 40 key informants from 19 states between May 2014 and March 2015. Discusses challenges and barriers to access as well as possible solutions.
Author(s): Susan M. Skillman, Davis G. Patterson, Cynthia Coulthard, Tracy M. Mroz
Date: 02/2016
Type: Document
Sponsoring organization: WWAMI Rural Health Research Center
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Report to Congress on Medicaid Disproportionate Share Hospital Payments
First annual report on Medicaid Disproportionate Share Hospital (DSH) payments, which provide support to safety-net hospitals to help offset uncompensated care costs for Medicaid and uninsured patients. Discusses Medicaid policy, current and future DSH allotments, and data needs. Table B-3 projects FY2018 DSH payments under different scenarios, with data for urban and rural hospitals and for Critical Access Hospitals.
Date: 02/2016
Type: Document
Sponsoring organization: Medicaid and CHIP Payment and Access Commission
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Community Health Workers: Roles and Opportunities in Health Care Delivery System Reform
Identifies and discusses health services research on the utilization and integration of Community Health Workers (CHWs) into healthcare service delivery. Includes an analysis regarding the various CHW models, employment data, training and credentialing, and challenges associated with the development of this occupation.
Author(s): John E. Snyder
Date: 01/2016
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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ACO Investment Model, Rural Hospital Collaboration
Highlights how 3 rural Minnesota hospitals implemented the Accountable Care Organization Investment Model (AIM), which encourages coordinated care in rural areas through upfront and ongoing Centers for Medicare & Medicaid Services (CMS) payments.
Date: 2016
Type: Document
Sponsoring organization: American Hospital Association Rural Health Services
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Rural Medicare Advantage Plan Payment in 2015
Examines how changes to the Medicare Advantage (MA) payment policy formula, which were implemented as part of the Affordable Care Act (ACA), are impacting MA plans and beneficiaries in rural and urban areas.
Author(s): Leah Kemper, Abigail R. Barker, Timothy D. McBride, Keith Mueller
Date: 12/2015
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Medicare Value-based Payment Reform: Priorities for Transforming Rural Health Systems
Analyzes the provisions within the Affordable Care Act (ACA) regarding Medicare payment and delivery system reforms that affect rural health providers and rural health services. Proposes recommendations that support the inclusion of rural appropriate payment systems.
Additional links: Policy Brief
Author(s): Keith Mueller, Charles Alfero, Andy Coburn, et al.
Date: 11/2015
Type: Document
Sponsoring organization: Rural Policy Research Institute Rural Health Panel
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Which Rural and Urban Hospitals Have Received Readmission Penalties Over Time?
Evaluates the rural-urban differences in the proportion of hospitals that receive penalties under the Centers for Medicare & Medicaid Services (CMS) Readmission Reduction Program, and compares the specific health condition risk-adjusted readmission rates by rural and urban location. Analyzes characteristics of hospitals receiving readmission penalties.
Author(s): Peiyin Hung, Michelle Casey, Ira Moscovice
Date: 10/2015
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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State Actions to Promote and Restrain Commercial Accountable Care Organizations
Identifies actions state governments can take to promote the benefits of Accountable Care Organizations (ACOs) while mitigating potential risks. Discusses rural-specific concerns related to solvency and exclusivity provisions. Also examines state policy tools that regulate and support both providers and payers. Section 2 offers ACO policy guidance specific to California.
Author(s): Nicholas C. Petris Center on Health Care Markets and Consumer Welfare
Date: 10/2015
Type: Document
Sponsoring organization: University of California - Berkeley
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Rural Delivery System Reform Takes Center Stage for National Advisory Committee
Reports on discussion at a September 2015 meeting of the National Advisory Committee on Rural Health and Human Services focused on the need for rural healthcare providers to be involved in health system changes related to payment and service delivery.
Author(s): Kate Menzies, Brandon Baumbach
Citation: Rural Monitor
Date: 10/2015
Type: Document
Sponsoring organization: Rural Health Information Hub
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National Advisory Committee Tackles Delivery System Reform, Child Poverty
Describes a September 2015 meeting of the National Advisory Committee on Rural Health and Human Services held in Mahnomen, Minnesota, which focused on rural child poverty and healthcare delivery system reform.
Citation: Rural Monitor
Date: 10/2015
Type: Document
Sponsoring organization: Rural Health Information Hub
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